A Maryland firm that oversees the nation’s largest independent network of primary care medical practices is facing a whistleblower lawsuit alleging it cheated Medicare out of millions of dollars using billing software “rigged” to make patients appear sicker than they were.

The civil suit alleges that Aledade’s billing apps and other software and guidance provided to doctors improperly boosted revenues by adding overstated medical diagnoses to patients’ electronic medical records.

“Aledade did whatever it took to make patients appear sicker than they were,” according to the suit.

For example, the suit alleges that Aledade “conflated” anxiety into depression, which could boost payments by $3,300 a year per patient. And Aledade decided that patients over age 65 who said they had more than one drink per day had substance use issues, which could bring in $3,680 extra per patient, the suit says.

The whistleblower case was filed by Khushwinder Singh, MD, in federal court in Seattle in 2021 but remained under seal until January of this year. Singh, a “senior medical director of risk and wellness product” at Aledade from January […]

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